Tracing the Journey of Endometrium, from Womb to Arm: Deltoid Endometriosis.
Deltoid
Dienogest
Excision
Extrapelvic endometriosis
Soft tissue tumor
Journal
Journal of obstetrics and gynaecology of India
ISSN: 0971-9202
Titre abrégé: J Obstet Gynaecol India
Pays: India
ID NLM: 0374763
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
16
07
2019
accepted:
12
11
2019
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
9
1
2021
Statut:
ppublish
Résumé
Endometriosis is an enigma. Extrapelvic endometriosis is even more challenging, as theories of origin are difficult to explain. Very few cases of skeletal endometriosis have been reported in the literature. We managed a case of 39-year-old nulliparous woman, who presented to the department of plastic surgery with complaints of a painful nodule measuring about 2 cm, in left upper arm since past 8 years. She had history of myomectomy 8 years back, while she was undergoing treatment for primary infertility. Differential diagnosis of extrapelvic endometriosis was made based on clinical history of cyclical pain and swelling, and she was referred to gynecology for hormonal treatment. MRI and FNAC were inconclusive. She underwent excision biopsy of the lesion. Histopathology confirmed intramuscular endometriosis of left deltoid with positive margins. Postoperatively, she was started on dienogest 2 mg once daily and LNG IUS was inserted. Both were withdrawn a year later, due to side effects. It has been more than 6 months since removal of LNG IUS, and currently she is asymptomatic. To the best of our knowledge, this is the third case of deltoid endometriosis reported till date.
Sections du résumé
BACKGROUND
BACKGROUND
Endometriosis is an enigma. Extrapelvic endometriosis is even more challenging, as theories of origin are difficult to explain. Very few cases of skeletal endometriosis have been reported in the literature.
METHOD
METHODS
We managed a case of 39-year-old nulliparous woman, who presented to the department of plastic surgery with complaints of a painful nodule measuring about 2 cm, in left upper arm since past 8 years. She had history of myomectomy 8 years back, while she was undergoing treatment for primary infertility. Differential diagnosis of extrapelvic endometriosis was made based on clinical history of cyclical pain and swelling, and she was referred to gynecology for hormonal treatment. MRI and FNAC were inconclusive. She underwent excision biopsy of the lesion.
RESULT
RESULTS
Histopathology confirmed intramuscular endometriosis of left deltoid with positive margins. Postoperatively, she was started on dienogest 2 mg once daily and LNG IUS was inserted. Both were withdrawn a year later, due to side effects. It has been more than 6 months since removal of LNG IUS, and currently she is asymptomatic.
CONCLUSION
CONCLUSIONS
To the best of our knowledge, this is the third case of deltoid endometriosis reported till date.
Identifiants
pubmed: 33417641
doi: 10.1007/s13224-019-01292-6
pii: 1292
pmc: PMC7758389
doi:
Types de publication
Journal Article
Langues
eng
Pagination
529-532Informations de copyright
© Federation of Obstetric & Gynecological Societies of India 2019.
Déclaration de conflit d'intérêts
Conflict of interestAll authors declare that they have no conflict of interest.
Références
Endoscopy. 2000 Jul;32(7):525-30
pubmed: 10917184
Skeletal Radiol. 2006 Aug;35(8):595-8
pubmed: 16308716
Acta Orthop Scand. 1991 Oct;62(5):497-9
pubmed: 1950501
Hum Reprod. 2014 Mar;29(3):400-12
pubmed: 24435778
Eur J Obstet Gynecol Reprod Biol. 2017 Oct;217:34-37
pubmed: 28846863